go back

New Mexico rates for HCPCS 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $214 · 10th–90th $123–$4270%10%20%10th90th$214Professionalmedian $158 · 10th–90th $110–$3890%10%20%10th90th$158$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $213.80 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $134.90 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $190.55 / $295.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $138.04 / $218.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $208.93 / $309.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $288.40